Solitary Intraosseous Neurofibroma of the Mandible: A Case Report

Background Solitary intraosseous neurofibroma of the mandible is a rare benign peripheral nerve sheath tumor. Owing to its low incidence and nonspecific clinical and radiographic features, diagnosis can be challenging. We report a rare case with extensive mandibular destruction and compare its clinical presentation, treatment, and outcome with those of previously reported cases. Case Presentation A 65-year-old woman presented with pain in the posterior mandible and lower-lip numbness. Imaging revealed an extensive osteolytic lesion involving the posterior mandibular body, mandibular angle, and lower ramus, with complete obliteration of the inferior alveolar canal and extensive cortical perforation. Histopathological examination demonstrated a spindle-cell tumor, and diffuse S-100 immunoreactivity supported the diagnosis of solitary intraosseous neurofibroma. Given the extensive local bone destruction, the patient underwent subtotal mandibulectomy followed by immediate reconstruction with a vascularized free fibular osteocutaneous flap. At the 10-month follow-up, no clinical or radiographic evidence of recurrence was observed. Conclusions Solitary intraosseous neurofibroma should be included in the differential diagnosis of osteolytic mandibular lesions. Comprehensive radiologic evaluation and histopathological confirmation are essential for accurate diagnosis and surgical planning. In cases with extensive mandibular destruction, subtotal mandibulectomy followed by immediate vascularized free fibular osteocutaneous flap reconstruction may provide satisfactory functional and reconstructive outcomes. Long-term follow-up is warranted because of the limited follow-up period in the present case.